Sida Evaluation 05/21:6
Turning Policy into Practice: Sida’s implemention of the Swedish HIV/AIDS strategy Zambia
Pol Jansegers
Department for Evaluation and Internal Audit
Turning Policy into Practice: Sida’s implemention of the Swedish HIV/AIDS strategy Zambia Pol Jansegers
Sida Evaluation 05/21:6 Department for Evaluation and Internal Audit
This report is part of Sida Evaluations, a series comprising evaluations of Swedish development assistance. Sida’s other series concerned with evaluations, Sida Studies in Evaluation, concerns methodologically oriented studies commissioned by Sida. Both series are administered by the Department for Evaluation and Internal Audit, an independent department reporting directly to Sida’s Board of Directors. This publication can be downloaded from:
http://www.sida.se/publications
Author: Pol Jansegers The views and interpretations expressed in this report are the author’s and do not necessarily reflect those of the Swedish International Development Cooperation Agency, Sida. Sida Evaluation 05/21:6 Commissioned by Sida, Department for Evaluation and Internal Audit Copyright: Sida and the author Registration No.: 2005-170 Date of Final Report: January 2005 Printed by Edita Communication AB, 2005 Appendix to Sida Evaluation 05/21 art. no. Sida4882en URN NBN: se-2005-29 ISSN 1401— 0402
SWEDISH INTERNATIONAL DEVELOPMENT COOPERATION AGENCY Address: SE-105 25 Stockholm, Sweden. Office: Sveavägen 20, Stockholm Telephone: +46 (0)8-698 50 00. Telefax: +46 (0)8-20 88 64 E-mail:
[email protected]. Homepage: http://www.sida.se
Table of contents List of abbrevations and acronyms ...............................................................................2 1. Introduction ..........................................................................................................5 2. Summary of findings and recommendations ...........................................................5 Recommendations to Sida’s head office: .................................................................................... 7 Recommendations to Sida – Zambia: ........................................................................................ 7 Recommendations to the regional HIV/AIDS team for Sub-Saharan Africa: ......................... 8 3. Background: HIV/AIDS situation and Sida’s cooperation with Zambia .......................8 4. Detailed findings of the evaluation .........................................................................9 4.1 Sida country staff ....................................................................................................................... 9 4.2 Projects and programmes supported by Sida ........................................................................... 11 4.3 Regional HIV/AIDS Team for Sub-Saharan Africa ............................................................... 15 5. Analysis of the evaluation findings ........................................................................18 5.1 Relevance of the IFFG ............................................................................................................. 18 5.2 Effectiveness of the implementation of the IFFG ................................................................... 18 5.3 Impact of the IFFG on planning, and on projects and programmes ....................................... 20 5.4 Constraints and barriers to the implementation of IFFG ........................................................ 20 5.5 Opportunities exploited, opportunities missed ......................................................................... 21 5.6 Lessons learned, including a comparison with other cross-cutting issues................................. 21 6. Recommendations ..............................................................................................22 6.1 To Sida’s head office ................................................................................................................. 22 6.2 To Sida in Zambia .................................................................................................................... 23 6.3 To the Regional HIV/AIDS Team for Sub-Saharan Africa .................................................... 23 Annex 1: Mission time table .......................................................................................25 Annex 2: List of persons met and interviewed .............................................................28 Annex 3: Documents consulted ..................................................................................31 Annex 4: List of Sida supported projects ....................................................................33
List of abbrevations and acronyms
(Sida’s) Department for Africa
Acquired Immune Deficiency Syndrome
s
Antiretroviral drugs
Agriculture Support Programme
Business Development Services
Central Board of Health
Comprehensive / Management Programme
Churches Health Association of Zambia
(Sida’s) Department for Democracy and Social Development
Department for International Development ()
District Health Management Team
Government of the Republic of Zambia
Health Economics and Research Department
Harmonisation in Practice Initiative
Human Immunodeficiency Virus
International Labour Organization
International Organization for Migration
Ministry of Agriculture and Cooperatives
Multi-country Program (World Bank)
Ministry of Foreign Affairs
MoU
Memorandum of Understanding
Million
National /// Council
Non-governmental organisation
Norwegian Agency for Development
+
Network of Zambian People Living with /
President’s Emergency Plan for Relief
People living with /
Poverty Reduction Strategy Paper
Regional Training Network
Swedish Krona ( = . Euros)
Sida
Swedish International Development Co-operation Agency
Small and medium-sized enterprises
Sexually Transmitted Infection
United Nations
Joint United Nations Programme on /
United Nations Development Programme
United Nations Children Fund
United States Agency for International Development
World Bank
World Food Programme
Zambia National Network
1.
Introduction
Case studies in four selected countries, Bangladesh, Ukraine, Ethiopia and Zambia constitute the third part of the evaluation of Sida’s implementation of Sweden’s / policy “Investing for Future Generations”. Zambia was one of the twelve countries for which the country strategy was reviewed in the first part of the evaluation, in order to assess to what extent the four strategic areas of support stated in the had been taken into account at the various levels of development cooperation. The present case study will try to assess how the , through the country strategy, has been transformed into concrete action, i.e., how effective it has been in enabling Sida to make an appropriate and adapted response to / in Zambia. The evaluation mission was performed between Tuesday November and Monday December by Pol Jansegers, one of the members of the core evaluation team. The mission time table is attached in Annex . Time was essentially divided between interviews of key informants, the review of a number of country-specific documents, and two field visits. The lists of persons met for discussions, of documents reviewed and of Sida supported projects are attached in Annexes , and .1 After a short description of the country’s / situation and Sida’s development cooperation with Zambia (Chapter ), the detailed findings of the evaluation mission are listed and analyzed (in Chapters and ), where, after a set of recommendations are provided to Sida’s head office, to the embassy and to the Lusaka-based regional / team for Sub-Saharan Africa (Chapter ). The author wishes to express his thanks to all the persons who have given their time for interviews, not the least to the staff of Sweden’s embassy in Lusaka, including the members in the regional / team for Sub-Saharan Africa, and to Jubilee Silwizya in particular, for the preparation of this mission. Special thanks go to Dr Simon Mphuka, Director of Programmes of the Churches Health Association of Zambia (), for accepting to be the national consultant for this evaluation and to make himself available in spite of a busy work schedule.
2.
Summary of findings and recommendations
• Zambia is a country with a mature / epidemic and a very visible impact of on all sectors of the society. Using the same scoring system as in the desk study where country strategy documents were reviewed, it would definitely have the maximum score of three, which indicates an extremely serious / situation, combined with strong links between the epidemic and all sectors for development cooperation. On the other hand, if Sida’s work in Zambia had to be summarized in one sentence, one could say that, at the present, it also reaches the highest score (three) on the scale of intensity of mainstreaming / in development work. The increased attention to / has not been uniform however: it seems to have become more pronounced since –, indicating that a relatively substantial time lag before the guiding principles of the could to be translated into concrete action.
1 Except for the agriculture sector, which has only one big project, the (described in section ..). TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
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Two striking – probably inter-dependent – factors have most likely played an important role in this development: – the high degree of competence of the staff at the embassy and the regional / team staff, and – the very high visibility of /-related issues in each and every activity of the society. Although it is difficult to appreciate the influence of the various other factors in play, the trend observed would indicate that, for instance, the more recent instructions for scaling up the response to / have been necessary to give additional strength to the . One can also conclude that the establishment in of both the / secretariat at the head office and the regional / team in Lusaka has been instrumental in boosting the implementation of the . • Sweden’s / policy, as it was laid down in “Investing for Future Generations” (), is generally recognized by all staff as the guiding principle for their work. Most of them see it primarily as an analytical and conceptual framework, convenient to be adapted to specific situations. As such, the is still a valid and useful document. However, the practical aspects of the strategy are lagging behind in terms of the today’s importance of mainstreaming /, and of the role of treatment. In fact, the guidelines and more recent instructions made by Sida’s head office and the may be considered as adjustments and complements to the strategy. • Meanwhile, / has been effectively integrated in Sida’s development work in Zambia, and mainstreaming / has become the ‘natural way’ of doing development cooperation for Sida staff. The same is true for other cross-cutting issues like gender and human rights, which reinforce rather than compete with each other. • The absence of an appropriate, ‘-sensitive’ and non-discriminatory workplace policy for embassy staff is in sharp contrast with the above, and could be potentially counter-productive, as it elicits criticism among national and development partners. • Sida was recognized by many of their peers as advocating for more coordination in the support from development partners. Sida plays a leading role in establishing joint financing agreements with a number of other bilateral donors of the so-called ‘like-minded group’, which favours coordination and is an opportunity to lobby for the adoption of progressive policy and innovative strategies. • Sida’s support to projects and programmes that specifically target / is relatively minor in comparison with total support in the health sector as well as in other sectors of development cooperation, i.e., essentially agriculture and democratic governance. In addition, the share of support going to s is quite marginal, compared to the amount of bilateral aid to the government. This is justified as follows: – focus on / is present in every project/programme through effective mainstreaming (the Agriculture Support Programme may be cited as an example of this, – bilateral aid, especially budget support, is better adapted to Sida’s working conditions in the field, particularly the relatively limited amount of staff available, and – the small amount of support to s is in a certain way the consequence of effective coordination with other development partners, who target civil society on a preferential basis. • The translation of the country strategy into concrete projects/programmes is in fact very much demand-driven: generally, the selection on what to support is made from project proposals submitted.
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That selection is based on the proposals’ coherence with the country strategy document, and, thus, on their adherence with national priorities and with Sweden’s policy on development cooperation in general, and on / in particular. Sida allows for substantial flexibility in that process: within their respective annual budgets and ‘right to enter into financial commitments’, the embassy and the regional / team can take funding decisions up to .2 This demand-driven aspect and the importance of core funding to the Ministry of Health make it essential to thoroughly review the proposals and requests for support for their coherence with the , and to closely monitor their implementation. • Since Sida relies very much on national partners for the implementation of their projects/programmes, the lack of institutional and human capacity in the public sector (especially the ) as well as in civil society (and even more so among the ) constitutes a serious constraint to the implementation of the . • The availability of substantial international funding for / (Global Fund, the World Bank’s , , etc.) constitutes a unique opportunity for Sida to concentrate on capacity building and coordination, which are two essential elements in the . • The regional / team is a highly professional team, with a great team spirit. The work it does for scaling up the Swedish response to / in Sub-Saharan Africa is impressive. It is a precious source of direct help for Sida staff at Sweden’s embassy in Lusaka, and probably also in other African countries. • The main recommendations of this report are the logical outflow of the above. They may be summarized as follows:
Recommendations to Sida’s head office: – To continue to advocate for the development and application of an appropriate and all-inclusive workplace policy for all embassy staff, national as well as ‘sent-out’. – To allow appropriate budget allocations to institutional and human capacity building in the project proposals submitted by cooperation partners.
Recommendations to Sida – Zambia: – To repeat the competence building exercise among its staff (support staff as well as professionals), and to extend it to their dependents. To promote competence building among other stakeholders as a means to build and strengthen local response. – To scale up support to the civil society, especially in the field of capacity building. – To promote the greater involvement of in the response to /, through pro-active recruitment of a to the embassy staff. To support specific training and capacity building for that purpose, within associations of . – To continue reviewing project proposals for their explicit adherence to national priorities and strategies, and to Sweden’s policy and principles, in particular concerning mainstreaming of /, gender, environment, etc. – To continue to play a leading role in the coordination of development partners, through advocacy in stakeholders’ meetings, basket funding agreements, etc. 2 means million Swedish kronor ( = . Euros). TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
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– To take appropriate measures to ensure that field experience is properly documented in selected projects, for example by requesting the inclusion of a documenting activity in the project proposal as a condition to access funding, and allowing adequate budget allocation for it.
Recommendations to the regional HIV/AIDS team for Sub-Saharan Africa: – To organize competence building exercises for professional and support staff in Swedish embassies in other African countries – To take the opportunity of the upcoming development of the new Swedish strategy for support for regional and sub-regional development cooperation in Sub-Saharan Africa in , to strengthen the mainstreaming of / in regional overall development work.
3.
Background: HIV/AIDS situation and Sida’s cooperation with Zambia
According to the most recent census in , Zambia has a population of . million, with per cent under the age of . According to ’s Human Development Report, the country ranks th out of countries, with a Human Development Index () of . (the average for the Least Developed Countries is .).3 Beginning in , the / epidemic has spread very rapidly, affecting primarily the major cities of the country. By , the epidemiological sentinel survey indicated a national prevalence rate of . per cent among the adult population, but several major cities showed infection rates of around per cent. More recently, however, encouraging trends were recorded among young pregnant women in several sites, but these cannot be extrapolated to the whole country. Likewise, the Zambia Demographic and Health Survey – showed an average infection rate of per cent among the population between and years. estimates that around one million people were living with at the end of .4 The epidemic is one of the most feminized in the world, with some places demonstrating an prevalence of per cent among women, against per cent among men. Married women, in turn, have higher infection rates than their single, never-married counterparts. The impact of the / epidemic on morbidity and mortality is already very visible: Zambia is one of the nine African countries where life expectancy at birth has dropped below years.5 According to the Human Development Report , it was down to . years in (making it the lowest in the world!). This, of course, has substantially increased numbers of orphans and child-headed households (estimated at about , in ), and deepened poverty of the general population. The impact on labour force is devastating, e.g. about , teachers died of during the year alone. Starting in , Sida has a long history of development cooperation with Zambia. In , the volume of that cooperation reached around , allocated mainly to the sectors of health ( ) and agricultural sectors ( ). Another important area of support is democracy and human rights, with a budget of . In the country strategy for to , it was clearly stated that / should be mainstreamed into all Swedish development cooperation projects and programmes. 3 The Human Development Index is a combination of health, education and economic indicators. 4 , “ Report on the global epicemic”. 5 , , “ epidemic update December ”. 8
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Support to the education sector was discontinued in , as the then prevailing conditions could not justify continued Swedish assistance. Several other bilateral agencies currently provide pooled funding to the Ministry of Education, but Sida is not among them. The needs for mainstreaming / in the education sector are still considerable.
4.
Detailed findings of the evaluation
4.1
Sida country staff
4.1.1
Working relationships with Sida’s head office, the regional team, and other embassy staff
The work of most embassy staff is in one way or another related to development cooperation, so – at least for the purpose of this case study – there is no noticeable difference between “Sida” and “embassy” staff. For easy reference, an early description of the staff of the embassy (including the regional / team for Sub-Saharan Africa) is attached in annex . All staff members involved in the present evaluation are the same as in that description, except for Pär Eriksson, who replaced Anna-Carin Kandimaa in August . Pär Eriksson’s duties are half bilateral and half regional. In the regional team, an additional adviser on culture and media arrived recently, and will spend per cent of her time on /. Nine embassy staff members were interviewed during this mission, including the head of administration and eight professionals directly involved in development cooperation, among them the ambassador, Mrs Christina Rehlen. The latter is a former Sida staff, which may account for her knowledge of and sensitivity to development issues and /. The regional / team for Sub-Saharan Africa is located in one of the buildings of the embassy, and there are very close working relationships between the entities. For practical reasons, the regional team will be discussed separately however, under section . below. Working relationships also seem to be very good among the embassy staff, and there is a good division of responsibilities between Swedish and Zambian staff members. Sida staff at the embassy in Lusaka is also in a very privileged position, as they can take benefit of the proximity and direct technical assistance from the regional / team. Both the embassy and the regional / team have substantial authority in the recruitment of their staff: for expatriate staff, they share this authority with Sida’s head office, while they have the entire responsibility for the recruitment of national staff. 4.1.2
“AIDS competence”6
competence seems to be excellent among all staff interviewed, on a personal as well as on a professional level. In the midst of , the embassy in collaboration with the regional / team organized a series of specific / sensitization and awareness-raising meetings at the embassy, for both professional and support staff (secretaries, drivers, etc.). The ‘Comprehensive / Management Programme’ (), the local organisation that ran the workshops, has an excellent reputation in that area in Lusaka, and apparently did a very good job. The embassy is planning to repeat the experience in for new staff, and as a ‘refresher’ for the other staff. 6 The Competence Programme of / ( Institute for Training and Research) describes ‘ competence’ as follows: “AIDS Competence means that we – as people in families, communities, in organisations and in policy making – acknowledge the reality of HIV and AIDS, act from strength to build our capacity to respond, reduce vulnerability and risks, learn and share with others and live out our full potential.” TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
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/, which is literally an integral part of everybody’s daily life in Lusaka,7 is also being discussed in various contexts in professional and other meetings. 4.1.3
Familiarity with, and attitude towards, the IFFG
All staff interviewed know about the ‘Investing for Future Generations” document, and recognize it as the overall / policy of Sweden. In fact, many staff members see it more as an analytical tool and a conceptual framework than as a ‘strategy’, which in fact makes it a more flexible tool to guide them in their development work. However, most of them agree also that the emphasis of some of the strategic goals of the should be better adapted to the present realities: for instance, more focus on treatment, including , more explicit promotion of the ‘/ mainstreaming’ concept, etc. 4.1.4
Attitude towards mainstreaming HIV/AIDS in development work
With no exception, staff find that mainstreaming of / needs to be done on a routine basis in all development work. This is no surprise, given that / is literally everywhere, and in everybody’s life, in Lusaka. The embassy staff also demonstrate a clear perception of the concept as a ‘way of doing development work’, and of its additional value to integrate / components into projects in various sectors. It follows that / is effectively being mainstreamed in all projects and programmes supported. Several informants mentioned that mainstreaming of / had been requested in project proposals submitted for support, before they could be accepted for funding. For instance, that was the case with the Business Development Services () and the Agriculture Support Programme (). 4.1.5
Relationships with:
• National cooperation partners Most – bilateral as well as multilateral – of the development partners interviewed, seem to adhere to the “Three Ones” principle (one action plan, one coordinating authority, one monitoring and evaluation system with regard to /), and so does Sida. The national strategic framework for / is in principle at the centre of all planned interventions. In addition, budget support and basket funding strengthen the ownership of the government, by putting it ‘in the driver’s seat’. However, management capacity at the National /// Council () is said to be very limited, and seems difficult to improve: the position of director general has been vacant for one and a half years (in the meantime, there is an acting director general, though). Due to unattractive salaries, political influence in appointments, etc., adequate human resources are often unavailable, even for capacity building made available by development partners.8 The , which according to the latest work plan was supposed to have a -person strong team by September , has only staffs at the present! This issue is being addressed by several donors, among them the World Bank and Sida. Together with four ‘like-minded’ bilateral cooperation agencies (Norway, the Netherlands, Ireland and Great Britain), Sida is now planning to provide joint funding for the strengthening of the , in particular its secretariat. A joint financing agreement is ready, but had not yet been signed at the time of this mission.9 7 It is, for example, striking that and -related issues are brought up in about half of all the articles – including those on sports and entertainment – in local newspapers every day! 8 Of the two million budget for training that was made available by the in , only , have been effectively used so far. 9 In the meantime, the agreement was signed on th of January , and the first disbursement has already been made. 10
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• Other development partners With the growing number of actors and increased volume of support, coordination among development partners has become even more crucial. Sida is a member of most of the important coordination mechanism in the field of /, i.e. the Expanded Theme Group on /, and some of the technical working groups at the .10 According to various informants, from outside as well as from inside the Swedish embassy, Sida has increasingly focused on inter-donor coordination, and has often taken the lead, not only among the so-called ‘like-minded’ development partners, but also in broader circles. It was already a leading agency in the development of the “Harmonisation in Practice Initiative () in , and is now, together with six other bilateral donors, the System and the World Bank, a co-signatory of the memorandum of understanding called “Co-ordination and Harmonisation of Government of the Republic of Zambia/Donor Practices for Aid Effectiveness in Zambia” (April ). Important agreements in this memorandum are the following: – leadership remains with the government – the government commits itself to the implementation of the Poverty Reduction Strategy Paper (), which will serve as an overall framework for national priority setting and planning – donors commit themselves to a better coordination and harmonisation of their support. 4.1.6
Sida’s workplace policy on HIV/AIDS
Although the issue has been brought to the attention of Sida and the Swedish authorities for a long time, and despite pressure from the – Swedish as well as national – field staff, Sida does not at the present have an explicit, all-inclusive workplace policy for its staff. For example, if the prevailing rules should be strictly applied, a Zambian staff member’s direct family members would not be entitled to health insurance, let alone treatment for /-related illness. According to our informants, the argument put forward by the Swedish Ministry of Foreign Affairs () seems to be that putting such policy in place is complicated since it would necessarily have to apply for all Swedish embassies in the world. However, the absence of an appropriate workplace policy, valid for national as well as Swedish staff and including / issues, could somehow hamper harmonious working relationships among the embassy staff, which, in Lusaka, is otherwise truly excellent. It also gives a blurred image of Swedish development cooperation, which on the one hand advocates such workplace policy to its cooperation partners, and on the other hand denies it to its own staff. In the meantime, the embassy has – quite luckily – not yet been confronted with / cases among its staff, and negotiations are under way with a local insurance company in Lusaka, to ensure health care coverage to Zambian staff ’s relatives. (However, this company has so far refused to cover and /.)
4.2
Projects and programmes supported by Sida
4.2.1
Specifically targeting HIV/AIDS
As already mentioned, the main areas for Sweden’s development cooperation in Zambia are health and agriculture, and to a lesser extent – at least in budgetary terms – democratic governance, private sector development, urban development and energy.
10 For the Country Coordination Mechanism () of the Global Fund, the donors have agreed on a rotation system. For the moment, the Netherlands, and the World Bank represent the donor community. TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
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By far the most important of the sectors supported is the health sector, with a total of around to be spent in .11 Yet, only a relatively small portion of this support is used for projects and programmes that directly target /. For the period –, with a total support of , the portion used for specific / projects/programmes was (or . per cent). This includes support for: • institutional capacity building for the , in a concerted effort with four development partners from the ‘like-minded group’ (the joint financing agreement dated November , for a total amount of about five million , to which Sida will contribute . , still has to be signed), and • three projects implemented by national s: Edu-Sport, Trendsetters (a youth media group with strong focus on / and sexual health and rights), and the Zambia National Network ().12 Table one below gives the breakdown of the budget for to according to the focus (i.e. health or /) and the channel used, as follows:
(MSEK) Government
Health
HIV/AIDS
Totals
263.5
5
268.5
7.5
7.5
NGOs Other
12.5
3.5
16
Totals
276
16
292
The table also demonstrates that only a very small share of health funding goes to s (. per cent), which seems to confirm an often heard remark in civil society circles: “Sida is for bilateral cooperation with government. If you [as an ] want support, go to Norad”.13 It should be recognized that support to s is relatively more labour-intensive, and hence less adapted to Sida’s working methods that rely on relatively few staff in the field. Again, Sida may wish to consider the priority needs of the country in relation with scaling up / activities, in the context of a significant human resources crisis in the public as well as in the private sector. Following the various instructions from Sida’s head office and more recently the (i.e. a letter dated August in which the clearly spelled out its “will to dramatically increase the /-oriented assistance through Sida”), an additional have already been budgeted for the period to for specific / projects. 4.2.2
Overall development projects and programmes that include HIV/AIDS components and/or mainstreaming
The largest part of the health sector support goes to budget support for primary health care: the socalled ‘district basket’ and ‘hospital basket’, with budgets of and respectively, for the period to , out of a total budget for health funding of (see Table ). The achievement of / mainstreaming in this support is based on the assumption that the government takes / effectively into account in the routine delivery of health services, something that could be verified through interviews with key-informants as well as during a field visit to the Lusaka District Health Management Team and the District Health Centre () of Kalingalinga. Just a few examples, to illustrate: 11 The figures given in this report are only indicative. As figures often cover periods of three or four years, and individual projects and programmes also cover different periods, it is very difficult to give exact budget figures. 12 The proposal had not yet been approved by the time of this mission. 13 That remark usually referred to the health sector. Conversely, much of the support from the democratic governance portfolio goes to s (see ..). 12
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• The country had set a target of , patients to be on treatment during , but had already exceeded that target at the end of November. • Prevention of Mother-to-Child Transmission () was started in , and is already available in more than of the s of Lusaka. More importantly, over per cent of the pregnant women in contact with the s accept to enter the programme. • Home based care is routinely proposed by public health care facilities to all clients put on treatment. Shortage of skilled staff was however mentioned by the district health authorities and field staff as a major obstacle for scaling up / care and support. But even so, the Central Board of Health () seemed to be quite optimistic about the possibilities of rapidly training sufficient doctors and even lower level health care workers in diagnostic and treatment protocols. Nevertheless, the considerable increase of the workload for health care providers, together with the loss of great numbers of skilled staff due to ‘brain-drain’ and – not least – to /, will definitely put a heavy burden on the sector’s human capacity. The Agriculture sector is the second largest recipient of Sida support, with almost annually. Virtually all Sida’s support in this sector goes to a five year programme with the Ministry of Agriculture and Cooperatives (): the Agriculture Support Programme, or . The programme aims at improving the livelihoods of small-scale farmers through improved food security and increased income from sales from agriculture produce. The evaluation team was given the opportunity to visit one of the ‘agriculture camps’ in the Chibombo District, where the local farmers regularly meet with the programme’s camp extension officers. Four characteristics in that meeting left a very favourable impression: • the way / was being mainstreamed, without necessarily naming it (for instance, promoting less labour-intensive farming methods in order to cope with reduced labour force, or crops with higher food value for improved health) • the very spontaneous and open discussion about / related issues, including faithfulness, gender roles, etc. • the strong community ownership of the programme: e.g. timing and subjects of the meetings were decided upon by the farmers themselves, and translation (for the benefit of the visitor) was done by one of the farmers • the good gender balance, not only in numbers (seven out of more or less participants were women), but also in terms of participation in the discussions. However, the programme has one serious constraint: so far, the selection process for participation in the programme has been such that the most needing households, such as child-headed ones, would automatically be denied access. It was suggested that collaboration could be sought with (Programme Against Malnutrition) or the World Food Programme (), to improve food security for ‘the poorest of the poor’. Besides the , Sida is also preparing support to the ministry’s Policy and Planning Department, where gender and / mainstreaming are included in the project plans. In that context, Sida is able to draw on considerable advocacy and sensitisation work already done by the United Nations’ Food and Agriculture Organisation (). Another area for sustained attention to / is the democratic governance portfolio, which works primarily with s. About half of the roughly projects supported (with a total budget of over for the year ) have / components (see annex , p. , projects marked with an asterisk). One may of course argue that all projects in that area, as they focus on democracy and human rights, do in fact mainstream /, as well as gender issues.
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Finally, with regard to Sida-funded projects in private sector development, urban development and energy sector, the evaluation team could witness efforts to mainstream /. This was illustrated in Sida’s support to for a project targeting long-distance truck drivers, and more specifically in the design of ‘Business Development Services’ (), a project to strengthen small and medium-sized enterprises (). When submitted the project proposal to Sida in , it was returned to them with the request that /-related issues should be taken into account, in view of the serious impact of / on small and medium-sized enterprises, due to absenteeism, attrition due to , etc. Support to the education sector ended in , due to the fact that the then prevailing conditions could not justify continued Swedish assistance. Several other bilateral agencies currently provide pooled funding to the Ministry of Education, but Sida is not among them. Given the crucial role education plays in building the youth’s resistance to the , and in view of the human resources crisis that the education sector faces as a consequence of /, Sweden might wish to reconsider its decision. 4.2.3
Planning process
• Partners involved To the extent that the projects proposed for funding fit in the framework of Sweden’s country strategy, the ‘planning’ of Sida’s yearly support is essentially demand driven. In that sense, Sida’s partners are those whose request for support has been approved. True partnership is concretized more during the process of writing the country strategy, during which Sida discusses with the national government about priority needs that are to be taken into account in the document. That method of working shows the importance of ) an effective and timely dialogue with the national partner during the country strategy process, and ) a thorough review of the project proposals submitted, for their adherence to Sweden’s policy and principles, especially in relation with the inclusion or mainstreaming of /-related, gender and other cross-cutting issues. One of the consequences of this working method (which in a certain way leaves the initiative for the provision of support with the implementing partners) is that the involvement of persons living with / () is very limited. In the past few years, Sida supported just two small projects with + (Network of Zambian People Living with /).14 Moreover, it was significant to hear that only two of the five permanent staff of this organization were actually , because of the difficulty to find the required skills among them. Like in many other countries, relatively few come out in the open, and those who do often lack the required technical competence. Their active involvement in / action is nevertheless crucial to expand the response to the epidemic, and more should be done to strengthen their technical capacity through pro-active recruitment and capacity building. For instance, the recruitment of a to the national embassy staff would be a very visible sign of acknowledging the essential role of in development work. Another characteristic of Sida support is the importance given to basket funding, which means that a number of bilateral donors (usually from the ‘like-minded group’ made up of the Nordic countries, , Ireland and the Netherlands), and with multilateral agencies occasionally joining in. Through the discussions to prepare such agreements, this can provide a forum to Sida to promote its policy among other development partners. Furthermore, using the strength of ‘speaking with one voice’ to their national partner is a unique opportunity for advocacy by the donors involved in basket funding.
14 Those projects (printing a booklet for , and one workshop on avoiding stigma towards ) have both been completed, and therefore do not appear in the list of Sida supported projects in annex . 14
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• Consideration of country needs As mentioned above, it is the country strategy process that will warrant the coherence of Sida’s support with the national strategic framework and other documents where national concerns are prioritized. Furthermore, the fact that most of Sida’s support goes to government programmes also ensures that country needs are duly taken into account. • Coordination with other development partners The importance of coordination among development partners for strengthening and expanding the national response cannot be over-emphasised. It is indeed essential for: • avoiding duplication • identifying important gaps in the response • allowing synergetic action, and • reducing the administrative burden placed on cooperation partners. Sida in general collaborates very well with other development partners, and often uses these partnerships for better harmonisation of development cooperation. Collaboration is even closer with countries of the ‘like-minded group’, and in particular with Norway. One Norwegian staff has been seconded to Sida’s regional / team, which in return provides technical support to Norwegian as well as to Swedish embassies. This arrangement is part of a cooperation agreement between the Norwegian and the Swedish governments. Sida is also a member of the most important coordination bodies, such as the Expanded Theme Group on /, and tends to be at the forefront of coordination efforts. As such, they participate in several multi-donor agreements with the Zambian government for basket funding, which is a strong tool for coordination. 4.2.4
Monitoring and evaluation
With few exceptions, monitoring is mainly done on the basis of activity reports from the implementing partners (sometimes quarterly but more often twice annually) and through annual project reviews. Due to the limited numbers of Sida staff in Zambia, only few field visits are carried out, and there is no direct supervision of the implementation of projects. The is an exception, where two Swedish consultants were recruited to assist in implementing and monitoring the project. Feedback on reporting is in principle only provided if ‘something has gone wrong’, and needs corrective action, otherwise, communication between Sida and implementing staff occurs at the annual project review meetings. It should be reminded that even positive feedback, i.e. when everything is on track, is still useful, just to keep contact, or to show that regular reporting is much valued. Thorough mid- and end-term evaluations, in such set-up of limited monitoring, are also imperative.
4.3
Regional HIV/AIDS Team for Sub-Saharan Africa
Currently, the regional / team for Sub-Saharan Africa in Lusaka has seven professional staff and one administrative assistant, but the team is likely to expand, due to Sida’s scaling up of / support both through bilateral and regional programmes and activities. Three more professional posts have therefore been requested, but only two of them (one sent-out regional adviser and one with a focus on monitoring and evaluation) will be filled during . The team is headed by a very dedicated team leader. She was the head of the Division for University Support and Bilateral Research Cooperation at Sida’s head office in Stockholm, before starting up the TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
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“expanded version” of the regional team in Lusaka, in September .15 The team was fully functional by the beginning of . At the present, it is a group with much cohesion and competence, where personal as well as professional matters can be discussed openly. From an administrative perspective, the team reports to the director of and has a close collaboration with the secretariat on thematic issues.16 The team has formed a reference group of seven regional experts, who represent various thematic areas. The group members have an advisory function to the team, through twice-annual meetings and ad-hoc consultations. They may also be called upon as resource persons for workshops and capacity building activities in various countries of the region. ‘Investing for Future Generations’ () is the principal policy document guiding Sweden’s regional development cooperation in terms of / in Sub-Saharan Africa. This policy – which is primarily considered an analytical tool or a conceptual framework by many informants – is promoted among Sida staff in various ways: • during the discussions about / policy in the bi-weekly meetings concerning the regional programmes • in the discussions at the project appraisal committee meetings • in thematic meetings, often in preparation of specific missions by Sida staff. However, due to extensive travel of the staff, those meetings are not regular enough, according to the head of the team • during activities arranged for embassy staff, e.g. – meetings organized by the regional team, such as the annual / focal points meetings, the workshop bringing together economists around the theme of / in February , etc. – thematic regional meetings organized by Sida’s head office, where the regional team staff acts as resource persons, – activities requested by embassies in Sub-Saharan African countries, talks on various subjects, etc. Like the rest of the embassy staff – and probably for the same reasons – the members of the regional team members are very supportive of / mainstreaming, and practice that approach on a routine basis. From a more personal perspective, the embassy organised, in collaboration with the regional / team, a series of in-depth discussions in June-July for all staff (including professionals, support staff, drivers, etc.) in view of increasing their competence. These talks seem to have had a profound effect on all those who participated, and will be repeated, in order to take staff turn-over into account. To complete these activities of competence-building and improving acquaintance with Sida’s / policy, the team is now in the process of developing an “/ introduction -” for the personal use by new embassy staff members. The aim is to have it available for the / focal point meeting in May , so that it may also be used in other countries for competence building purposes. The main tasks of the regional / team are: • The implementation of regional development cooperation on /. 15 Originally, a three-person strong regional / team was established in Harare, but had serious difficulties to function appropriately. 16 By the time of the evaluation mission, the team still reported to the head of . The change mentioned here took place shortly after the end of the mission. 16
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• The collaboration with the Norwegian and Swedish embassies in Sub-Saharan Africa, as a resource base for both capacity building and technical assistance.17 • Information and communication on / issues in development cooperation and research for policy development and south-south collaboration. The team tries to achieve good synergy between regional programmes and collaboration with the embassies, by assigning bilateral responsibilities and tasks to team members in accordance with their specific competence and experience from regional programmes. 4.3.1
Responsibilities and tasks at regional level
The table below shows the indicative figures for the volume of Sida’s regional total development cooperation and the share allocated to the response to / respectively. The regular increase of Sweden’s support for overall development in Sub-Saharan Africa appears clearly, and the growth of the budgets for regional / activities is even more significant: it was more than doubled from to , and will increase again by about per cent for .
(indicative, in MSEK) Regional development cooperation Regional HIV/AIDS activities
2003
2004
2005
700
800
900
56
114
165
It must be said that / – unlike gender equality, which was explicitly mentioned as a cross-cutting issue – did not occupy a very visible place in the Swedish regional strategy document for the period to . A mid-term review of that strategy was foreseen during , but has not yet been carried out. That review, and the development of a new strategy in , should be an opportunity to better mainstream /. Following the example of the overall regional development cooperation, the regional / team has identified two categories of regional programmes: those where regional cooperation is essential, and others where regional programmes give an added value, such as exchange of experience and information, south-south cooperation in research and higher education, etc. After a regional response analysis, the evaluation team decided to look at the following three programme areas in particular: • migrant and mobile populations • food security • capacity building for rapid scaling-up of / efforts. Regional programmes are mainly implemented through support to inter-governmental organisations (regional or sub-regional), multilateral development partners including the -related organisations (including , , , , , etc.), and s working regionally. 4.3.2
Work in relation with individual countries of the region
When / activities take place in Lusaka, the members of the regional team staff members often act. They are also involved in specific training and other activities in the various countries of the region (currently about twelve), and provide technical backstopping to those countries (by visits, e-mail and other communication means), as and when requested by the Swedish and Norwegian embassies. To that effect, the various staff members try to the extent possible to make a geographical division of tasks between 17 Given the proximity, the embassy in Lusaka is the first to benefit from their help. TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
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themselves, while giving priority to their thematic expertise. As already mentioned, the members of the reference group are also used as resource persons for the embassies, and the team intends to expand its technical support through the creation of a ‘Mobile Virtual / Task Team’, in . The regional team also provides regular information and communication to the embassies through the monthly e-mail newsletter hiv@africa, and is an important contributor to the quarterly “Eyes on ”, published by Sida’s head office. Communication with the head office, and in particular with the / secretariat, occurs on a continuous basis by e-mail, telephone, etc.
5.
Analysis of the evaluation findings
5.1
Relevance of the IFFG
“Investing for Future Generations” is often considered by our informants from the embassy staff and regional team as an analytical and conceptual framework, rather than as a real ‘strategy’. It is indeed quite general, and needs to be complemented with further guidelines in order to serve as a tool for practical implementation. Even so, its generic nature enables it to remain relevant in a variety of countries and situations, and flexible enough for adaptation to specific circumstances. Hence, the is still a valid policy orienting document: • the analysis that it contains is still relevant, despite the fact that so much has changed in the field of / since it was developed in , • the guiding principles can still be applied, although their respective emphasis may have to be adapted to different circumstances. However, the practical aspects of the no longer seem to be adapted to the realities of today. This is particularly true for areas concerning: – treatment and care, an area that has seen developments inconceivable only five years ago, in the field of treatment for opportunistic infections, and – the need for mainstreaming / in development work, which is unquestionable in countries as severely hit by the epidemic as Zambia – the importance of coordination among development partners.
5.2
Effectiveness of the implementation of the IFFG
5.2.1
With regard to development cooperation
The focus on / seems to have evolved in two phases since : a rather slow increase until –, where after a much faster evolution occurred both through specifically targeted interventions and through more generalized mainstreaming of / in overall development work (see section .. above). The more recent instructions from Sida’s head office and the for scaling up the response to / have accelerated that movement. As a result – and most probably also because of the very visible epidemic in the country – the is presently being implemented effectively in Zambia, in accordance with the strong focus on / 18
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in the country strategy document. One could even say that its implementation goes beyond the prescriptions of the original document with regard to the effective mainstreaming of / in the entire development work, and strong coordination among development partners. Relatively little attention was given so far to treatment and care, however. Of course, many development partners have already lined up for the procurement of drugs, but there is an urgent need for capacity building in view of improving service delivery. Those needs exist in the public sector as well as in the civil society. Not much effort has been made to involve persons living with / in the design or in the implementation of / projects/programmes, mainly because their technical capacity is not sufficient. It was therefore suggested to support capacity building among , in order to enable them to play such roles, and subsequently, to recruit a to the Zambian staff at the embassy. The regional / team does considerable work in Sub-Saharan Africa in the areas of scaling up, mainstreaming, coordination and improved communication among stakeholders. Appreciating the impact of such endeavours in other countries – except for Ethiopia, where a case study will be done in January – is beyond the scope of this evaluation, however. At the national level, support to research in the field of / is being addressed through research capacity building in training institutions. It is however a much more important activity for the regional / team, in various ways: • through support to several regional education and research institutions and training networks (e.g. 18 and 19 etc.) • through the organisation and support to seminars and training workshops in the different countries of the region • through the support from the regional experts of the ‘reference group’, who report from conferences and workshops that they attend. 5.2.2
With regard to own staff
As already mentioned, the absence of a workplace policy including / for embassy staff, is in contrast with the overall attitude of the embassy authorities. Even if the embassy in Lusaka is currently negotiating measures to ensure health care coverage including / for its Zambian staff and their relatives as well as for the Swedish staff, it is nevertheless a fact that national staff and their direct relatives, in the absence of an all-inclusive workplace policy, so far have to rely on the goodwill of the embassy authorities. Even though the itself does not address the issue of workplace policy as such, various other documents and facts clearly illustrate the importance given to it in Sida’s strategies: • The guidelines on “How to Invest for Future Generations” () and numerous other Sida documents mention workplace programmes, and stress the need to avoid discrimination on the basis of -status. • One of the case studies reported on in “One Step Further – Responses to /”, published in , even gives the examples of a diamond mining company in Botswana that put in place a progressive / workplace policy. • One of the regional programmes, with a budget of close to , implemented in collaboration with the international council of Swedish industry, is nothing less than “Development of / workplace policies at Swedish-related companies in Southern and Eastern Africa”! One of the informants interviewed put it in a very concise way: “Sida should do what they preach to others!” 18 stands for “Health Economics and Research Department”, at University of Natal, South Africa. 19 stands for “Regional Training Network”, Nairobi, Kenya. TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
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5.3
Impact of the IFFG on planning, and on projects and programmes
It is a fact that / has a very prominent place in development work in Zambia. However, one may assume that different factors have contributed to that, and even that they probably have influenced each other. Such factors include: • the influence of the itself • the “post-” instructions for scaling up from Sida’s head office and the • the influence of Sida’s head office, in particular the / secretariat • the establishment of the regional / team in Lusaka • the emphasis put on / in the country strategy • the personality and dedication of those responsible for implementing Sida’s response to / in Zambia or in Sub-Saharan Africa • the pressure exercised by the local situation and very visible impact of / on every-day life. It is reasonable to expect that the provided the appropriate framework, and has functioned as the engine to drive at least the following three or four elements in that list, but to determine each factor’s individual share would be impossible with just one case study. Therefore, the comparison of the findings in all four case studies will be essential to provide clues to the impact of the factors above (and others). What can be said with certainty, though, is that the last factor in the list, i.e. the pressure from the local situation, has played a significant role in Zambia. On the other hand, some characteristics of its mode of work tend to limit Sida’s control on the implementation of the : • Sida’s support is essentially demand driven. Sida’s freedom of choice is thereby limited by the variety of these projects that are proposed to it, and by their coherence with the national priorities and strategies as well as with Sida’s own policy and principles. • Core funding or budget support constitutes a considerable part of Sida’s bilateral support (for instance, over the period to , close to per cent of Sida’s total support to the health sector has gone to the Ministry of Health for primary health care in districts). It is therefore crucial to closely monitor the government’s policy and strategies, as well as their implementation in decentralized areas, for their accordance with the . • Basket funding, which is frequently used in collaboration with the ‘like-minded group’, is in fact a double-edged sword: while it represents an opportunity to influence development partners’ policy, and constitutes a strong tool for advocacy towards the cooperation partner, it requires at the same time some flexibility in order to reach agreements on a common goal.
5.4
Constraints and barriers to the implementation of IFFG20
• Given the relative importance of the government for Sida’s support in Zambia (more than per cent of the funding in the health sector go through that channel), the weakness of the ’s management and coordination capacity is certainly the most serious threat to the efficiency of that support, and thereby also to the effective implementation of Sida’s policy as outlined in the . Sida’s 20 A purely technical/material constraint, not directly related to the implementation of the , but which in the long run could hamper efficient communication, is the fact that computer equipment at the embassy is outdated (e.g. the absence of ports on computers does not allow the use of memory sticks). 20
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decision to join efforts with four other bilateral development partners in an ambitious project of capacity building is therefore a judicious one, even though it contains a certain degree of risk. • Absorptive capacity is in general rather weak, both in the public sector and in civil society. A situation where human resources were limited, mainly due to unattractive salaries or working conditions, has been further aggravated during the last years by the devastating impact of on the labour force. That is particularly true in the field of treatment and care. But it is also the case in the area of prevention, and more specifically with regard to building up local responses through increasing competence among the actors as well as among the communities, which is labour-intensive and time consuming. • The need for human capacity building is even greater for , whose lack of technical capacity is often a constraint for their involvement in project design and implementation. • The absence of a valid, all-inclusive workplace policy for Sida personnel could end up being counter-productive to the implementation of the (“You don’t do yourself what you preach!”)
5.5
Opportunities exploited, opportunities missed
• The agreement among several donors to engage in ‘basket funding’ certainly conveys a strong message to the cooperation partner about the importance those donors attach to the issue concerned, and puts them in a strong position to negotiate the adoption of strategic options, like the . This opportunity is actually being utilized in a domain of critical importance for the implementation of the : the institutional capacity building of the . More such opportunities will arise, as and when the work plan of this institutional strengthening will be implemented. They should be identified in a timely way, and used judiciously. • Considerable funding – in the case of Zambia, over a hundred million – has become available over the last years, through the Global Fund, the World Bank’s Multi-country Programmes (), the ‘President’s Emergency Plan for relief ’ (), etc. This is a unique opportunity to address crucial and expensive issues like treatment and care, which is one of the four strategic areas of the . Yet the effective use of those funds is subject to availability of appropriate skills and human capacity. In order not to miss that opportunity, institutional and especially human capacity building is not only important, but also urgent! Better skilled human resources will not only improve absorptive capacity, but they will also be essential to attain the ‘ by ’ target for therapy and other Millennium Development Goals, and to expand the response to / in general. • There may be good and bad projects, but there is only good experience: a poor result or even a failure can provide as valuable an experience as a success story, as long as the appropriate lessons are drawn, and used in future projects. It is therefore extremely useful for national as well as development partners to be able to benefit from the experience of one another. Several of our informants were of the opinion that Sida could do better in the area of documenting the projects and programmes they support. One of them put it in a rather eulogistic way: “Sida people are too humble!” Of course, documenting good or best practice is time consuming. A solution could be to include ‘documenting experience’ as a requirement for accessing funding, and to allow the implementing partner (especially s) to budget the cost for this activity.
5.6
Lessons learned, including a comparison with other cross-cutting issues
• One lesson learned in the interviews with the staff from the embassy and the regional team staff in Lusaka was the beneficial impact of the ‘ competence-building exercise’ organized in . This increased competence – on a personal as well as on a technical level – and has probably been instrumental in building commitment, and in improving the relevance and appropriateness of the
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An example of HIV/AIDS mainstreaming: The Agriculture Support Programme (ASP) (see Section 4.2.2) HIV/AIDS is being mainstreamed on a routine basis in the meetings of the local farmers with the programme’s camp extension officers. To that purpose, each of the roughly 200 facilitators (extension officers) of the programme was given a two week training course when starting the job, during which he/she learned to mainstream different cross-cutting issues including good governance, gender perspective and, not the least: HIV/AIDS. During the monthly meetings, discussions very naturally address issues like less labour-intensive farming methods to cope with reduced labour force, or crops with higher food value for improved health, etc. All the farmers know that those are strategies to reduce the impact of AIDS on their work, and the men and women attending the meetings very openly discuss issues related to HIV and AIDS, as well as gender equality.
response elicited. It would be worthwhile sharing this lesson with Sweden’s embassies in other countries, and maybe even in Sida’s head office. • Taking into account several cross-cutting issues at the same time, such as /, gender equality, environment, etc. was in general seen as a natural way of working. In particular, gender and / were usually seen as inseparable and reinforcing each other. Again, this may be facilitated by the evidence appearing in the day-to-day life, as it was illustrated in the field visit to the (see .. above). • The illustrated the value of empowerment of local communities, how this can warrant more effective implementation, and how it can improve sustainability. The importance of the role of target populations – individuals – as actors rather than as ‘recipients’ is also a lesson to be documented and widely shared.
6.
Recommendations
6.1
To Sida’s head office
– To consider reviewing and updating the , keeping its strategic framework, but adapting the relative focus on the various parts to the present situation, in particular concerning: • care and treatment for , including • mainstreaming of / in development work, and its relevance to low as well as high prevalence countries • coordination of support among development partners. – To put in place an appropriate workplace policy for all embassy staff with: • non-discriminatory rules for sent-out as well as locally recruited staff and their direct dependents, • regulations on health care coverage for / and , etc. – To put sufficient emphasis on institutional and human capacity building among the implementing partners, and to allow appropriate budget allocations to that purpose in the project proposals. 22
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– To provide sufficient support for documenting field experience, including technical assistance and logistic support at the head office level.
6.2
To Sida in Zambia
– To repeat the competence building exercise among its staff (support staff as well as professionals), and to promote it among other stakeholders as a means to build and strengthen local response. – To scale up support to the civil society, especially in the field of capacity building. In that perspective, support should be considered for umbrella-organisations such as and , in order to allow them to have a multiplying effect in capacity building among their members, and to better play their role as principal recipients for the Global Fund. – To promote the greater involvement of in the planning, implementation, monitoring and evaluation of / projects/programmes, and in more general development cooperation, and to support specific training and capacity building to that purpose. In that perspective, to consider the recruitment of a to the Zambian staff of the embassy. – To continue to review all project proposals for their explicit adherence to national priorities and strategies, and to Sweden’s policy and principles, in particular concerning mainstreaming of / , gender, environment, etc. – To continue playing a leading role in the coordination of development partners, through advocacy in stakeholders’ meetings, basket funding agreements, etc. – To use the strength of basket funding (‘several donors, one voice’) for the promotion of commonly agreed upon strategies and principles, in particular those of the . – In order to allow ‘the poorest of the poor’ to have better access to the and to improve their food security, to seek collaboration with the Programme Against Malnutrition and/or the World Food Programme (). – To take appropriate measures to ensure that field experience is properly documented in selected projects, for example by requesting the inclusion of a documenting activity in the project proposal as a condition to access funding, and allowing adequate budget allocation for it.
6.3
To the Regional HIV/AIDS Team for Sub-Saharan Africa
– To initiate competence-building exercises for professional and support staff in other embassies in Africa. – To take the opportunity of the upcoming mid-term review of the Swedish Strategy for Support for Regional and Subregional Development Cooperation in Sub-Saharan Africa, –, to strengthen the / mainstreaming in regional overall development work.
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Annex 1: Mission time table Time
Interviewee/Activity
Position
Organisation
Tuesday 30 November 06:50
Arrival on BA255, and check-in in Intercontinental Hotel
12:00
Working lunch with Anita Sandström and Paul Dover
14:30–15:30
Dr Rosemary Shunkutu
16:00
Document review
Regional HIV/AIDS Team for Sub-Saharan Africa Senior Health, Nutrition & Population specialist
World Bank MAP Unit
HIV/AIDS program officer
ASP
Food Security Officer
Regional HIV/AIDS Team
Wednesday 1 December 08:00
Joyce Banda (for whole day field visit to Chibombo)
15:00
Back to Lusaka
16:00
Davies Chitundu
Thursday 2 December 9:00–11:00
Document review
11:00–12:00
Elizabeth Mataka
Executive Director
ZNAN
Marta Levitt-Dayal
HIV/AIDS
USAID
Lunch 15:30–16:30
Friday 3 December 9:00–10:00
Roland Msiska
Director, Regional HIV/AIDS Programme
UNDP (South Africa in relation to visit 2.12)
10:30–11:30
Anette Widholm
Regional Adviser/Culture
Embassy of Sweden
Anita Sandström
Head of Team
Regional HIV/AIDS Team
Position
Organisation
Lunch 14:00–16:30
Saturday 4 December Sunday 5 December Time
Interviewee/Activity
Monday 6 December 09:00–11:00
Christina Rehlen, Kristina Kuhnel, Audrey Mwendapole, Pär Eriksson,
Ambassador, Economist/ Counsellor, HIV/AIDS focal point, Program officer Health
Embassy of Sweden
11:00–12:00
Paul Dover
Adviser Reg.HIV/AIDS Team Member
Embassy of Sweden
12:15–13:00
Alfred Sikazwe, Ms Ireen Malambo
HIV/AIDS focal point
Ministry of Education
Bright Phiri
Communicator Officer HIV/ AIDS Team Member
Embassy of Sweden
Lunch 14:00–15:00
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15:30–16:30
Mr Kieran Hayward
Director
Edu-Sport
Tuesday 7 December 9:00–10:00
Kunyima Banda
Programme Officer
NZP+
10:30–11:30
Mr Louis Ndabahagamye, Dennis Zulu, Mpala Mulenga
Director, Program Officer, Coordinator of Social & Economic Impact of HIV/AIDS on the Workplace
ILO
11:30–12:00
Tapera Muzira
Chief Technical Adviser
BDS
12:00–13:00
Rikard Elfving
Adviser Reg.HIV/AIDS Team Member
Embassy of Sweden
14:30–15:30
Tony Dely
HIV/AIDS focal point
DfID
15:30–16:30
Masuka Mutenda
Program Manager
Youth Media (Trendasetters)
Lunch
Wednesday 8 December 9:00–10:00
Oyvind Thiis
Adviser Reg.HIV/AIDS Team Member
Embassy of Sweden
10:30–11:30
Hope Situmbeko
Program Officer – Private Sector
Embassy of Sweden
12:00–13:00
Norlin Sofia
BBE (associate expert)
Regional HIV/AIDS Team
Lunch 14:30–15:00
Kristine Johnssen
Norwegian Embassy
Thursday 9 December 9:00–10:00
Pär Eriksson
Program officer Health
Embassy of Sweden
10:30–11:30
Pio Pamela, Jernberg Inger
NPO democr. gov /urban PO Democratic governance
Embassy of Sweden
12:00–13:00
De Figueiredo Pedro
PO natural resources
Embassy of Sweden
Time
Interviewee/Activity
Position
Organisation
14:30–16:30
Dr Kabaso, + Field visit to DHC Kalingalinga
Clinical Care Expert
Lusaka DHMT (+ Field visit)
17:00
Dr Karen Sichinga, Dr Simon Mphuka
Health Programmes Manager
CHAZ
Lunch
Friday 10 December 9:00–10:00
Catherine Sozi
UNAIDS Country Coordinator
UN Annex
10:00–10:30
Gunnarsson Jimmy
Head of Administration
Embassy of Sweden
10:30–11:30
Dr Mutali
Manager of Programmes
National AIDS Council
12:30–13:00
Haritiana Rakotomamonjuy
OVC program officer
UNICEF
14:00–15:00
Göran Carlsson
Senior adviser Central Board of Health(Sida financed)
CBoH
16:00–17:00
Audrey Mwendapole
Programme Officer, Health (Focal Point HIV/AIDS)
Embassy of Sweden
Lunch
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TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
Saturday 11 December 17:00
Anita Sandström/Debriefing
Head of Team
Regional HIV/AIDS Team
Director General
CBoH
Sunday 12 December Monday 13 December 9:00–10:00
Dr Ben Chirwa
10:30
Preparation of debriefing
Lunch 15:30–16:30
Debriefing at Embassy
Tuesday 14 December 09:05
Departure with BA254
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Annex 2: List of persons met and interviewed Embassy of Sweden Rehlen, Christina
Ambassador
Jernberg, Inger
First Secretary (democratic governance)
de Figueiredo, Pedro
First Secretary (natural resources and the environment)
Kuhlen, Kristina
Counsellor/Economist
Mwendapole, Audrey
Programme Officer, health (focal point /)
Eriksson, Par
Programme Officer, health
Pio, Pamela
Programme Officer, democratic governance/urban development
Situmbeko, Hope
Assistant Programme Officer, private sector development
Gunnarsson, Jimmy
Head of administration
Regional HIV/AIDS Team for Sub-Saharan Africa Sandström, Anita
Head of regional team
Chitundu, Davies
Food security officer
Widholm, Anette
Regional Adviser on culture and media
Dover, Paul
Regional Adviser, research, mobile populations
Phiri, Bright
Communication Officer
Elfving, Rikard
Regional Adviser, orphans and vulnerable children ()
Thiis, Oyvind
Regional Adviser, human rights
Norlin, Sofia
Associate Expert ()
National HIV/AIDS/STI/TB Council (NAC) Mutali, Dr
Acting Manager of Programmes
Ministry of Health District Health Management Team
Dr Kabaso
Clinical Care’s Expert
District Health Center Kalingalinga
Kunda, Evelina
Head Nurse
Sumanya, Sylvia
Nurse
Khosa, Caroline
Nurse
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Central Board of Health Chirwa, Ben
Director General
Carlsson, Göran
Senior Adviser
Ministry of Education Sikazwe Katewa, Alfred
Director, Standards & Curricula
Malambo, Ireen
/ Focal Point
UNAIDS Sozi, Catherine
Country Coordinator
UNDP Msiska, Roland
Director Regional Programme on and Development (Pretoria, S. Africa)
UNICEF Rakotomamonjy, Haritiana
Project Officer – /
ILO Ndaba, Louis
Executive Director
Zulu, Dennis
Programme Officer, / Focal Point
Mpala, Mulenga
Coordinator Social & Economic Impact of / on the Workplace
Muzira, Tapera
Chief Technical Adviser of Business Development Services ()
World Bank Shunkutu, Rosemary
Senior Health, Nutrition and Population specialist
Churches Health Association of Zambia (CHAZ) Mphuka, Simon
Director of Programmes
Sichila-Sichinga, Karen
Health Programmes Manager
Agriculture Support Programme (ASP) Banda, Joyce
/ programme officer
Makasa, Victor
Central Province Facilitation Team Leader (Chibombo)
Kalifungwa, Anthony
Chibombo District Coordinator
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Youth Media (“Trendsetters”) Phiri-Tembo, Mary
Executive Director
Masuka, Mutenda
Programme Manager
Edu-Sport Hayward, Kieran
Acting Director
Zambia National AIDS Network (ZNAN) Mataka, Elisabeth
Executive Director
Network of Zambian People Living with HIV/AIDS (NZP+) Banda, Kunyima
Programme Officer
DFID Daly, Tony
Adviser, Health & /
Norwegian Embassy Johanssen, Kristin
Second Secretary
USAID Levitt-Dayal, Marta
30
Team Leader of / Multisector Office
TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
Annex 3: Documents consulted Concerning Zambia-Sweden’s bilateral cooperation • Hamusimbi Coillard, “ (Agriculture Support Programme) – Impacts of / on Agriculture, Food Security and Business Activities among Target Groups, Final Report”, October , Lusaka, Zambia. • Sida, Department for Africa, “Country strategy for development cooperation with Zambia, January , – December , ”. • Sida, “Country Analysis – Zambia”, November . • Sida, “Performance Analysis – Zambia”, November . • Ministry of Foreign Affairs, Sweden, “Country strategy for development cooperation with Zambia, January, – December, ”. • Audrey Mwendapole, Embassy of Sweden, Lusaka, “Swedish Support to Combating / in Zambia”, Memo, Lusaka, February, . • Audrey Mwendapole, Embassy of Sweden, Lusaka, “Strategy on /” (draft), November . • Audrey Mwendapole, Embassy of Sweden, Lusaka, “Zambia Country Plan –”. • ‘Specific Agreement between the Government of Sweden and the Government of Zambia on Sector Programme Support to the Health Sector –’, Lusaka, December (Assessment Memorandum attached). • Memorandum of Understanding: ‘Co-ordination and Harmonisation of /Donor Practices for Aid Effectiveness in Zambia’, Lusaka, April . • Embassy of Sweden, ‘Assessment Memo – Support to the National /// Council and Secretariat, Lusaka, September . • Joint Financing Agreement () between The Royal Netherlands Embassy, the Embassy of Sweden, the Embassy of Ireland, the Department of International Development, United Kingdom, and the Ministry of Foreign Affairs, Norway and The National /// Council of Zambia, regarding the Implementation of the National /// Intervention Strategic Plan – , (draft November ). • (Agriculture Support Programme), Report on “Impacts of / on Agriculture, Food Security and Business Activities among Target Groups”.
Concerning Regional HIV/AIDS Team • Sida, “Swedish Strategy for Support for Regional and Subregional Development Cooperation in Sub-Saharan Africa, –”. • Regional / Team for Africa, “Regional programs, agreed or under preparation”, //. • Regional / Team for Africa, “Workplan for ”.
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• Regional / Team for Africa, ‘Country Plan for Regional / Development Co-operation –’, Lusaka //. • Lawrence Gelmon, “The regional response to / – An analysis of activities in Sub-saharan Africa”, June . • Sandström, Anita, ‘The Regional / Team, internal organisation and distribution of tasks in relation to increasing collaboration with Embassies and to the increasing regional portfolio’, November . • Virginia Bond & Gideon Kwesigabo (ed.), “Forging the Links against – / Research, Policy and Practice”, Sida, June . • – Zambia, ‘First Narrative Interim Report [on Sweden-Sida’s contribution for] .
Other • National /// Council, ‘The / epidemic in Zambia’, September . • Deloitte, ‘Final Report – The National /// Council, Work Plan and Budget for to ’, Lusaka, August . • Zambia National Network, ‘Project Proposal: Information Sharing and Capacity Building of Member Organizations’, submitted to Swedish Embassy, Lusaka, November . • Ministry of Foreign Affairs, Norway, ‘Norwegian Policy Positions – / and Development, Oslo, October . • , ‘Support to Mainstreaming in Development’, Secretariat Strategy Note and Action Framework –.
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Annex 4: List of Sida supported projects Health Sector 1) HIV/AIDS Name
Length
Period
Volume (SEK)
Status
Edusport’s Kicking AIDS Out Project
3 years
2003–2005
3 Million
Planned
(1 M per year) 3 years
Youth Media’s
2003–2005
Trendsetters Project
2 Million
Planned
(1 M per year)
(advanced) Completed
Youth Media’s
Nov. 2003
350 000
Evaluation of Trendsetters
-May 2004
(one off payment)
2003–2005
5 Million
Decision taken
(1M in 2003,
Agreement to be signed
National AIDS Council
3 years
Capacity building
2M in 2004 & 2005) Zambia National AIDS Network
2 years
2004–2005
2 Million
Indicative
IOM (HIV prevention in Ukwimi refugee camp)
1 year
2002–2003
2.5 Million
Completed
Zambian Initiative HIV prevention in refugee camps in Western province
1.5 year
Capacity building
(one off payment made in 2002) 2002–2004
1 200 865 (one off payment made in 2002)
Agreed, support may be extended to 2005 with 1 MSEK
2) Health Name
Length
Period
Volume (SEK)
Status
Health Services Basket
4 years
2002–2005
168 Million
Agreed
Hospital Basket
3 years
2003–2005
45 Million
Agreed
(15 Million per year) Training Institutions Capacity Building
4 years
2002–2005
14 Million
Agreed
Health Economics
4 years
2002–2005
10 Million
Agreed
Health Systems Development – CBOH
4 years
2002–2005
14 Million
Agreed
Policy & Planning – MOH
4 years
2002–2005
6 Million
Agreed
CboH Advisors
4 years
2002–2005
16.4 Million
Agreed
Planned Parenthood Association of Zambia (PPAZ) Institutional capacity building
3 years
2003–2005
2.5 Million
Agreed
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Democratic governance portfolio 2003
2004
Political participation
Parliamentary Reform: Stage 2
1,000,000
A
2,000,000
A
FODEP
665,000
A
1,000,000
P
NGO Support through Diakonia (*)
1,700,000
A
5,000,000
A
NGOCC
750,000
A
(Diakonia support)
National Women’s Lobby Group
500,000
A
(Diakonia support)
Mindolo Ecumenical Foundation
700,000
A
800,000
Women for Change (*)
(Diakonia support)
Total
5,115,000
A
8,800,000
Access to justice
Judiciary Capacity Building
2,500,000
A
2,500,000
A
Juvenile Justice project
590,000
A
910,000
A
UNZA Law School Project
1,000,000
A
0
HURID
1,000,000
A
1,000,000
A
NGO Support through Rädda Barnen (*)
2,500,000
A
2,500,000
A
Local Resources Foundation
1,000,000
A
1,000,000
A
CCJDP Paralegal Project
500,000
A
1,000,000
A
LAZ. Nat. Legal Aid Clinic
500,000
A
500,000
A
YWCA (*)
0
(Diakonia support)
State Reporting (Outstanding Financial Audit) Zambia Civic Education Association (ZCEA) (*)
(Rädda Barnen support)
Total
10,590,000
9,410,000
Free and independent media
MISA-Zambia (*)
1,000,000
A
1,000,000
A
Yatsani Radio Project (On-going)
0
A
0
A
Media Trust Fund (Norwegian Embassy) ZAMCOM (Outstanding Financial Audit Report) Total
34
1,100,000
1,100,000
TURNING POLICY INTO PRACTICE: SIDA’S IMPLEMENTION OF THE SWEDISH HIV/AIDS STRATEGY – ZAMBIA – Sida EVALUATION 05/21
Transnarencv and Accountability
AFRONET
500,000
A
400,000
A
Netherlands Embassy)
500,000
A
600,000
P
Total
1,000,000
1,000,000
Grand Total
17.805.000
20.310.000
TI-Zambia (discussing with
(*): Projects with / components
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2004–08–06
Programme
AIDS and Rights Alliance of Southern Africa, preparation of support.
Support to African Journal of AIDS Research.
East African Development Communications Foundation, EADCF. Edutainment for youth on prevention and dealing with stigma and discrimination.
Hope for African Children Initiative. Regional program (partnership between Care, Plan International, Save the Children Alliance, World Vision and Society for Women and AIDS in Africa) on orphans and vulnerable children.
University of Natal. Preparation of support for development of a training unit, for development of a health systems research program and for dissemination activities.
Institute for Democracy in Southern Africa, Budget information system. Comparative research; five countries in Africa and five countries in Latin America. Continued collaboration with IDASA under preparation (IDASA-BIS + Electoral processes)
International Federation of Red Cross in co-operation with the Swedish Red Cross. Regional programme with home-based care through national RC organisations in 10 countries in Southern Africa.
International HIV/AIDS Alliance. Support for the Africa work plan Continued cooperation under preparation
Earlier support from Sida HQ for project in transport and informal sector. Initial preparation of continued support.
Organisation
ARASA
CADRE
Femina-hip
HACI-Plan Sweden
HEARD
IDASA-BIS
IFRC-SRC
IHAA
ILO
Regional programs, agreed or under preparation
Regional HIV/AIDS Team for Africa
Nairobi
Cameron, DRC, Ethiopia, Ghana, Kenya, Malawi, Mali, Mozambique, Namibia, Senegal, Tanzania, Uganda, Zambia.
Pan African
Southern Africa: Botswana, Zimbabwe, Zambia, South Africa, Swaziland, Malawi, Namibia, Lesotho,Angola,M ozambique
In Africa: Botswana, Kenya, Mozambique, Namibia, South Africa
2002–2004
2002–2006
Harare
Brighton
2002–2004
2004–2005
2002–2005
2004–2004
2004–2006
Agreement period
Cape Town
Durban
Dar es Salaam
Tanzania, (Kenya)
Sub-Saharan Africa
South Africa
Namibia
Head-quarter
Sub-Saharan Africa
Southern Africa
Region/ countries
6 000 000
30 000 000
2 710 000
18 000 000
12 400 000
800 000
Agreed amount, SEK
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37
Nine countries in Southern Africa: South Africa, Zimbabwe, Zambia, Malawi, Mozambique, Botswana, Lesotho, Swaziland, Namibia Eastern and Southern Africa.
International Organisation for Migration. Continued support to HIV/AIDS program for refugees now being repatriated to Angola
Swedish Industrial Council/Swedish Metal workers union. Development of HIV/AIDS workplace policies at Swedishrelated companites in Southern and Eastern Africa.
Planning grant for a study on HIV/AIDS and media in Southern Africa.
Project support group. Programme focussing on migrant/mobile populations and cross-border activities.
Regional AIDS training network. Core support.
Regional Psychosocial Support Initiative for Children Affected by AIDS. Core support.
Southern Africa AIDS information Dissemination Service. Core support “AIDS in Africa. Continent in Crisis”. Special support to the translation of the book by Helen Jackson to French and Portuguese.
Southern African Network of AIDS Service Organisations. Core support.
IOM-Ukimwi II
NIR/SMF
PANOS
PSG
RATN
REPSSI
SAfAIDS
SANASO
Southern Africa
Southern Africa Pan African
Seven countries in Southern Africa: Namibia. South Africa, Zambia, Malawi, Zimbabwe, Tanzania, Mozambique
Southern Africa
Kenya, South Africa, Zambia
Angola, Zambia
Southern Africa.
International Organisation for Migration. Support given to a review/baseline study. As a result of the study a cooperation has been initiated on a regional network on HIV/AIDS and migration, PHAMSA. SADC is also supporting the initiative with a grant from the EC.
IOM-PHAMSA
Region/ countries
Programme
Organisation
Harare
Harare
Bulawayo
Nairobi
Harare
Lusaka
Stockholm
Lusaka
Pretoria
Head-quarter
2000–2003
2004–2007 2003–2004
200205–200705
2003–2005
2002–2006
2003–2004
2004–2007
2004–2005
2003–2006
Agreement period
4 000 000
9 000 000 2 200 000
27 040 000
6 000 000
17 000 000
500 000
30 912 500
9 200 000
15 000 000
Agreed amount, SEK
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Programme
A social science research program in cooperation with African social science research organisations – Council for the Development of Social Science Research in Africa, CODESRIA – Organisation for Social Science Research in Eastern and Southern Africa, OSSREA – Social Science and Medicine Network, SOMANet – Union for Population Studies, UAPS Delegated from the Dept. for Research Cooperation, SAREC, at Sida HQ.
Training facilitators and screening of the STEPS films (films on stigma and discriminations). The project is a partnership between Social Transformation and Empowerment Projects, STEPS, and International Videofair, IVF.
The TASO Experiential Training Project. Under preparation
Support to the project “AIDS in Africa. Building scenarios to shape the future”.
UNDP Regional HIV/AIDS Program. Capacity building programme for mainstreaming of HIV/AIDS in development.
Sub Saharan Africa
UN-Habitat. Building capacity for municipal governments and other stakeholders to deal with the impact of HIV/ AIDS.
A program based on the rights of children who have lost their parents due to HIV/AIDS. The programme gives support to legislation, empowerment of communities with social work, psychosocial counselling and funding through civil society and local government. Cooperation with the Division for Democracy and Sida HQ. Support to a rapid assessment
Organisation
Social Science Research Organisations
STEPS-IVF
TASO
UNAIDS
UNDP
Continued cooperation under preparation.
UN-Habitat
UNICEF-OVC
Nairobi Nairobi
Botswana, Tanzania, Zambia and Zimbabwe. Sub-Saharan Africa
2002–2004 2004
2004–2005
Nairobi
Blantyre (Malawi), Louga (Senegal) Abidjan (Ivory Coast), Arusha (Tanzania), Markudi (Nigeria)
2003–2004
20 000 000
Geneva
2001–2003
Pretoria
Pan African
Kampala
Sub Saharan Africa
30 000 000 1 000 000
6 350 000
500 000
16 650 000
6 830 000 7 200 000
Dakar Nairobi
Cape Town
5 040 000
Addis Ababa
28 500 000
Agreed amount, SEK
7 500 000
2003–2006
Agreement period
Dakar
Head-quarter
Southern Africa
Sub Saharan Africa
Region/ countries
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SWEDISH INTERNATIONAL DEVELOPMENT COOPERATION AGENCY SE-105 25 Stockholm, Sweden Tel: +46 (0)8-698 50 00. Fax: +46 (0)8-20 88 64 E-mail:
[email protected]. Homepage: http://www.sida.se
